ACIP June 2024: Key Vaccine Recommendations – RSV, COVID-19 & More

The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) convened from June 26-28, 2024, to review data and formulate recommendations for several vaccines, including those targeting respiratory syncytial virus (RSV), COVID-19, influenza, and pneumococcal disease. These recommendations, once reviewed and adopted by the CDC Director, will shape official public health guidance on vaccine use across the United States and are published in the Morbidity and Mortality Weekly Report (MMWR).

Protecting Older Adults and Those at Risk: RSV Vaccine Recommendations

A key focus of the meeting was the review of three RSV vaccines – from GSK, Moderna, and Pfizer – specifically for adult populations. Prior to the COVID-19 pandemic, RSV was estimated to cause a significant burden of disease in older adults, leading to approximately 60,000–160,000 hospitalizations and 6,000–10,000 deaths annually among those aged 65 years and older in the U.S.

The committee reached unanimous decisions regarding RSV vaccination. Adults aged 75 and older should receive a single dose of an RSV vaccine. Adults aged 60 to 74 who are at increased risk of severe RSV disease – those with chronic medical conditions like lung or heart disease, or residents of nursing homes – are also recommended to receive a single dose. This represents a significant step in preventative care for a vulnerable population.

Expanding Access: Vaxelis for American Indian and Alaska Native Infants

ACIP also addressed vaccine access for specific populations, voting unanimously to include DTaP-IPV-Hib-HepB (Vaxelis) alongside PRP-OMP (PedvaxHIB) in the preferential recommendation for American Indian and Alaska Native (AI/AN) infants, based on the Haemophilus influenzae type b (Hib) component. The Vaccines for Children (VFC) resolution for Vaxelis was also approved, further facilitating access to this vaccine.

Universal COVID-19 Vaccination for All Ages

In response to ongoing data demonstrating the continued importance of vaccination against COVID-19, ACIP unanimously recommended that everyone ages 6 months and older receive the updated 2024–2025 COVID-19 vaccine, as authorized or approved by the Food and Drug Administration (FDA). The updated vaccine is anticipated to be available in the fall of 2024, aiming to provide optimal protection against currently circulating strains. This broad recommendation underscores the ongoing need for vigilance against the virus.

Influenza Vaccine Strategy for the 2024-2025 Season

The committee also reviewed recommendations for influenza vaccines for the upcoming 2024-2025 season. Updated vaccines will be trivalent, protecting against an H1N1, H3N2, and a B/Victoria lineage virus. ACIP unanimously recommended routine vaccination for all individuals 6 months and older. For solid organ transplant recipients aged 18-64 who are taking immunosuppressive medications, both high-dose (HD-IIV3) and adjuvanted (aIIV3) inactivated influenza vaccines were deemed acceptable options, without a preference over other age-appropriate vaccines.

Fresh Pneumococcal Vaccine Option: PCV21

ACIP also considered the role of PCV21, a pneumococcal conjugate vaccine covering 81% of serotypes commonly found in adults, as an option for those aged 19 years and older who currently have a recommendation to receive a pneumococcal vaccine. The committee unanimously recommended PCV21 as a viable alternative, expanding the choices available to healthcare providers and patients.

Ongoing Discussions and Future Considerations

Several topics remain under discussion. The committee is revisiting the adolescent meningococcal vaccine schedule to optimize protection, considering recent epidemiological data, the duration of vaccine-induced protection, and the availability of a new pentavalent (ABCWY) vaccine from GSK. This discussion will continue at the October 2024 ACIP meeting.

RSV Immunization: Early Real-World Data

Initial real-world data on the safety and effectiveness of RSV immunizations for infants were presented, following the launch of a maternal vaccine and a long-acting monoclonal antibody (nirsevimab, Beyfortus) during the 2023-2024 season. Data indicate that nirsevimab was effective in reducing RSV-associated emergency department visits and hospitalizations. The CDC continues to recommend RSV immunizations to protect all infants from severe disease.

HPV Vaccine Work Group Launched

A new work group on Human Papillomavirus (HPV) vaccines has been established, with its first meeting scheduled for July 2024. This group will examine current dosage recommendations, refine language surrounding the recommended age for routine vaccination, and develop sub-group guidance on shared clinical decision-making for individuals aged 27 to 45.

What’s Next: From Recommendation to Implementation

The recommendations made by ACIP are not immediately implemented. They undergo review by the CDC Director. If adopted, these recommendations become the official CDC public health guidance for vaccine use in the U.S. And are formally published in the MMWR. This process ensures a thorough evaluation of the evidence and a consistent approach to public health messaging. Individuals should continue to stay informed about vaccine recommendations through official CDC updates and consult with their healthcare providers for personalized advice.